HIVID
General description

Hivid is the brand name for zalcitabine, formerly called ddC, produced by Roche Laboratories. It is a synthetic pyrimidine nucleoside analogue active against HIV infection. Hivid is available in tablet form.

Mechanism

Zalcitabine is enzymatically converted to an active form which inhibits HIV reverse transcriptase activity in two ways. It competes for utilization of a natureal substrate and it incorporates itself into viral DNA, terminating viral DNA chain growth. This drug also inhibits DNA polymerase activity in its active form.

Indications

Hivid is indicated to be used in combination with other antiretroviral agents to treat HIV infection.

Usage/Dosage

The general recommendation is one 0.750 mg tablet every 8 hours. For patients with creatine clearance 10 to 40 mL/min, a reduced dosage of 0.750 mg every twelve hours is recommended, and for a creating clearance of less than 10 mL/min, 0.750 mg every 24 hours is recommended. This drug is to be used in combination with other treatment.

Precautions

Patients with lowered CD4 cell counts appear to have higher rates of incidence of adverse effects. Patients should be informed that Hivid is not a cure for HIV infection and that they may continue to acquire illnesses associated with HIV infection and are still able to transmit HIV to other people. Use of Hivid concomitantly with drugs associated with peripheral neuopathy is not recommended. These include chloramphenicol, cisplatin, dapsone, disulfiram, ethionamide, glutethimide, gold, hydralazine, iodoquinol, isoniazid, metronidazole, nitrofurantoin, phenytoin, ribavirin, and vincristine. Hivid has been shown to be teratogenic in mice in a lab setting.

Contraindications

Hivid is contraindicated for any patients with a hypersensitivity to any of the drug components. It should not be used with didanosine.

Potential Adverse Effects

The major adverse toxic effect of hivid has been peripheral neuropathy characterized by numbness, nurning dysthesia, and sharp pain. Other more rare effects are pancreatitis, hepatic toxicity, oral and esophageal ulcers, heart failure, and anaphylactoid reaction. These other effects, however, occur very rarely.